Emergent Stenting In Acute Vertebrobasilar Occlusions

Not Applicable

Completed

• Conditions: Acute Stroke; Ischemic Stroke, Acute; Vertebro Basilar Ischemia
• Interventions: Procedure: Emergent Stenting

• Registration Number: NCT06129721
• Lead Sponsor: Can Tho Stroke International Services Hospital

Brief Summary

In the acute posterior circulation strokes, the vertebrobasilar occlusions frequently related to worse outcomes than the anterior ones. However, few studies mentioned the benefit and safety of the emergent stenting in the successful recanalization at these complex occlusions. The investigators investigated whether the improvement of clinical outcome was achieved in postprocedural 3-month.

Detailed Description

Acute ischemic stroke in posterior circulation account for nearly 20 - 25%, in which large vessel occlusions (LVOs) occur 0.8% - 5.7%. Although mechanical thrombectomy (MT) has recently been the gold standard in LVOs treatment, the futile recanalization (defined as unfavorable outcome despite early successful recanalization of target artery) rate was showed in posterior circulation higher than in anterior one. Multiple randomized controlled trials (BEST, BASICS, BAOCHE, ATTENTION) have recently reported the benefit of endovascular treatment better than of standard medical treatment for acute vertebrobasilar occlusions stroke. Besides, up to 36% LVOs with underlying intracranial stenosis and 64% with tandem lesions occured in the acute vertebrobasilar stroke. This was a reason why emergent stenting was considered to support the successful recanalization in the setting of failure of mechanical thrombectomy. Moreover, the successful recanalization is one of the independent predictors of good outcomes. However, the use of the loading dose dual antiplatelet therapy and peri-procedural complications made the safety of emergent stenting remain uncertain. Therefore, we aimed to investigate whether the impact of emergent stenting on the improved clinical outcome in vertebrobasilar occlusions.

Study Timeline

• Study Start: 2020-12-01
• Study First Submitted: 2023-11-08
• Study First Submitted QC: 2023-11-08
• Study First Posted: 2023-11-13
• Primary Completion: 2024-01-05
• Status Verified: 2024-02
• Study Completion: 2024-02-16
• Last Update Submitted: 2024-02-29
• Last Update Posted: 2024-03-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 38

Inclusion Criteria

• Age > 18 years old
• Onset to treatment time < 24 hours
• NIHSS ≥ 10
• pc-ASPECTS ≥ 5 on MRI

Exclusion Criteria

• Premorbid mRS > 2
• Extensive, bilateral brain-stem infarction on neuroimaging
• Cerebellar mass effect on neuroimaging

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Emergent Stenting	Emergent Stenting	Emergent Stenting In Acute Vertebrobasilar Occlusions

Primary Outcome Measures

Name	Time	Method
The favorable 3-month outcome rate	3 months	The favorable 3-month outcome rate was accessed by modified Rankin Score (mRS), which comprised of included good (mRS 0 - ≤ 2) and fair (mRS 3).

Secondary Outcome Measures

Name	Time	Method
The symptomatic intracerebral hemorrhage rate	24 hours after emergent stenting	The symptomatic intracerebral hemorrhage was defined as patient's intracerebral hemorrhage with postprocedural mRS ≥ 5 and there were no other evident causes for the increased mRS

Trial Locations

Locations (1)

Can Tho Stroke International Services Hospital; 🇻🇳 Can Tho, Vietnam